Localization of SP- and CGRP-immunopositive nerve fibers in the hip joint of patients with painful osteoarthritis and of patients with painless failed total hip arthroplasties
Localization of SP- and CGRP-immunopositive nerve fibers in the hip joint of patients with painful osteoarthritis and of patients with painless failed total hip arthroplasties
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DOI：
10.1016/j.ejpain.2005.12.011
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发表时间：
2007-01-01
影响因子：
3.6
通讯作者：
Hanesch, Ulrike
中科院分区：
文献类型：
--
作者：
Saxler, Guido;Loeer, Franz;Hanesch, Ulrike
用免疫组织化学方法检测了股骨颈骨折(对照组)、痛性骨关节炎(组2)和无痛人工全髋关节置换术(组3)患者髋关节内SP和CGRP免疫阳性神经纤维的存在。1、2组大鼠髋臼软组织及髋关节囊滑膜内膜下均有免疫反应神经纤维分布。对照组髋关节囊内CGRP免疫反应阳性神经纤维密度中位数为5.7纤维/cm2，SP免疫反应阳性神经纤维密度中位数为3.2纤维/cm2。在骨关节炎组，CGRP阳性神经元的密度中位数为15.6纤维/厘米(2)，SP阳性神经元的密度中位数为8.2纤维/厘米(2)(p=0.05)。髋关节置换失败的患者完全缺乏这些含有神经肽的传入神经。在骨性关节炎患者的髋臼中，CGRP-ir和SP-ir传入纤维密度的中位数分别为14.1和5.9纤维/cm(2)。根据这些数据，我们假设髋关节囊和髋臼窝的软组织是痛觉的重要触发因素。在松动的全髋关节置换术中，我们未能检测到SP和CGRP免疫反应纤维的患者没有感到疼痛的事实支持了这一事实。关节炎阶段SP和CGRP阳性神经元的上调表明，神经肽参与了疼痛退行性关节疾病的维持和调节来自周围的伤害性刺激。此外，这些发现有助于解释临床观察，例如通过关节内注射、滑膜切除和去神经手术来控制髋关节疼痛的局部治疗的有效性。(C)2006年欧洲国际疼痛研究协会分会联合会。爱思唯尔有限公司出版。保留所有权利。
Using immunohistochemical methods we determined the presence of SP- and CGRP-immunopositive nerve fibers in the hip joint of patients with femoral neck fracture (controls, group 1), painful osteoarthritis (group 2), and painless failed total hip arthroplasties (group 3). Immunoreactive nerve fibers were found in the soft tissue of the fossa acetabuli as well as in the subintimal part of the synovial layer in the hip joint capsule of groups 1 and 2. In the capsule of controls the innervation density had a median of 5.7 fibers/ cm 2 for CGRP-ir and 3.2 fibers/cm(2) for SP-ir afferents. In the osteoarthritic group, the density significantly increased to a median of 15.6 fibers/cm(2) for CGRP-ir and 8.2 fibers/cm(2) for SP-ir neurons (p = 0.05). Patients with failed hip arthroplasties completely lacked these neuropeptide containing afferents. Innervation density in the fossa acetabuli of osteoarthritc patients showed a median of 14.1 fibers/cm(2) for CGRP-ir and 5.9 fibers/cm(2) for SP-ir afferents. From these data we assume that the hip joint capsule and the soft tissue of the fossa acetabuli are important triggers of nociception. This is supported by the fact, that patients with loosened total hip arthroplasties, where we failed to detect SP- and CGRP-immunoreactive fibers, did not feel pain.The upregulation of SP- and CGRP-positive neurons in response to arthritic stages suggests a mechanism involving neuropeptides in the maintenance of a painful degenerative joint disease and in mediating noxious stimuli from the periphery. Furthermore, these findings help to explain clinical observations, such as effectiveness of local therapy to control hip pain with intraarticular injection, synovectomy and denervation procedures. (C) 2006 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.